US20100106106A1 - Reduced-pressure, wound-closure and treatment systems and methods - Google Patents

Abstract

A reduced-pressure, wound closure system is presented that generates a closing force on a surface wound and optionally provides reduced pressure to a body cavity or tissue site. The sealed contracting member, when placed under reduced pressure, generates the closing force. One illustrative system includes a first attachment member and a second attachment member, a sealed contracting member coupled to the first attachment member and the second attachment member, and wherein the closing force is generated between the first attachment member and the second attachment member when reduced pressure is supplied to the sealed contracting member. Other systems and methods are presented.

Description

RELATED APPLICATIONS
• The present invention claims the benefit, under 35 USC §119(e), of the filing of U.S. Provisional Patent Application Ser. No. 61/109,410, entitled “Reduced-Pressure, Wound-Closure System and Method,” filed Oct. 29, 2008; U.S. Provisional Patent Application Ser. No. 61/109,486, entitled “Reduced-Pressure, Abdominal Treatment System and Method,” filed Oct. 29, 2008; U.S. Provisional Patent Application Ser. No. 61/109,390, entitled “Open-Cavity, Reduced-Pressure Wound Dressing and System,” filed Oct. 29, 2008; and U.S. Provisional Patent Application Ser. No. 61/109,448, entitled “Reduced-Pressure, Deep-Tissue Closure System and Method,” filed Oct. 29, 2008. All of these provisional applications are incorporated herein by reference for all purposes.
BACKGROUND
• The present invention relates generally to medical treatment systems and, more particularly, to reduced-pressure, wound-closure and treatment systems and methods.
• Whether the etiology of a wound, or damaged area of tissue, is trauma, surgery, or another cause, proper care of the wound is important to the outcome. Unique challenges exist when the wound involves locations that require reentry, such as the peritoneal cavity and more generally the abdominal cavity. Many times when surgery or trauma involves the abdominal cavity, establishing a wound management system that facilitates reentry allows for better and easier care and helps to address such things as peritonitis, abdominal compartment syndrome (ACS), and infections that might inhibit final healing of the wound and the internal organs. In providing such care, it may be desirable to remove unwanted fluids from the cavity, help approximate the fascia and other tissues, or finally to help provide a closing force on the wound itself at the level of the epidermis. Unless otherwise indicated, as used herein, “or” does not require mutual exclusivity.
• Currently, an abdominal opening on the epidermis may be closed using sutures, staples, clips, and other mechanical devices to allow the skin to be held and pulled. Such devices often cause puncture wounds or can cause other wounds. If severe edema occurs, tremendous pressure may be placed on the closure device and the pressure may cause harm. For example, if the pressure rises due to edema, the sutures may tear out.
• With respect to an overall system for allowing reentry into the abdominal cavity, a number of techniques have been developed. One approach is to place towels into the cavity and then use clips, such as hemostats, to close the skin over the towels. While simple and fast, the results are regarded as suboptimal. Another approach is the so-called “Bogota bag.” With this approach, a bag is sutured into place to cover the open abdomen in order to provide a barrier. Still another approach, sometimes called a “vac pack,” is to pack towels in the wound and then place a drain into the abdomen and cover the abdomen with a drape. Finally, a reduced pressure approach has been used. Such an approach is shown in U.S. Pat. No. 7,381,859 to Hunt et al. and assigned to KCI Licensing, Inc. of San Antonio, Tex. U.S. Pat. No. 7,381,859 is incorporated herein by reference for all purposes.
SUMMARY
• Problems with existing wound closure devices and reduced-pressure treatment systems are addressed by the systems, apparatus, and methods of the illustrative embodiments described herein. According to one illustrative embodiment, a reduced-pressure, wound-closure system for providing a closing force to a surface wound on a patient includes a first attachment member for releasably attaching to a first portion of the patient's epidermis proximate an edge of the surface wound and a second attachment member for releasably attaching to a second portion of the patient's epidermis proximate the edge of the surface wound. The first attachment member is spaced from the second attachment member. The reduced-pressure, wound-closure system further includes a sealed contracting member coupled to the first attachment member and the second attachment member and operable to contract when placed under reduced pressure. The reduced-pressure, wound-closure system is operable to develop a closing force between the first attachment member and the second attachment member when reduced pressure is supplied to the sealed contracting member.
• According to another illustrative embodiment, a reduced-pressure, wound-closure system for providing a closing force to a surface wound on a patient includes a first attachment member for releasably attaching to a first portion of the patient's epidermis proximate an edge of the surface wound and a second attachment member for releasably attaching to a second portion of the patient's epidermis proximate the edge of the surface wound. The first attachment member is spaced from the second attachment member. The reduced-pressure, wound-closure system further includes a circumferential wall that is coupled to the first attachment member and the second attachment member. The reduced-pressure, wound-closure system further includes a sealed contracting member coupled to at least a portion of the circumferential wall and operable to contract when placed under reduced pressure. A reduced-pressure source is fluidly coupled to the sealed contracting member and is operable to deliver a reduced pressure to the sealed contracting member. A closing force is developed when reduced pressure is supplied by the reduced-pressure source to the sealed contracting member.
• According to another illustrative embodiment, a reduced-pressure, wound-closure and treatment system for providing a closing force to a surface wound on a patient and for delivering reduced pressure to tissue site includes a wound-closing subsystem and a reduced-pressure treatment subsystem.
• According to another illustrative embodiment, a method of manufacturing a reduced-pressure, wound-closure system for providing a closing force to a surface wound on a patient includes the steps of: forming a first attachment member for releasably attaching to a first portion of the patient's epidermis proximate an edge of the surface wound and forming a second attachment member for releasably attaching to a second portion of the patient's epidermis proximate the edge of the surface wound. The method of manufacturing a reduced-pressure, wound-closure system further includes forming a sealed contracting member operable to contract when placed under reduced pressure and coupling the sealed contracting member to the first attachment member and the second attachment member.
• According to another illustrative embodiment, a method for providing a closing force to a surface wound on a patient includes the steps of releasably attaching a first attachment member to a first portion of the patient's epidermis proximate an edge of the surface wound and releasably attaching a second attachment member to a second portion of the patient's epidermis proximate the edge of the surface wound. The first attachment member is spaced from the second attachment member. The method of providing a closing force further includes providing a sealed contracting member and fluidly coupling the sealed contracting member to the first attachment member and the second attachment member. The sealed contracting member is operable to contract when placed under reduced pressure. The method of providing a closing force further includes supplying a reduced pressure to the sealed contracting member, whereby a closing force is developed between the first attachment member and the second attachment member.
• Other objects, features, and advantages of the illustrative embodiments will become apparent with reference to the drawings and detailed description that follow.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is a schematic cross-section, with a portion presented as a block diagram, of an illustrative embodiment of a reduced-pressure, wound-closure and treatment system;
• FIG. 2 is a schematic, cross-sectional view of a portion of the reduced-pressure, wound closure and treatment system ofFIG. 1;
• FIG. 3A is a schematic, perspective view of an illustrative embodiment of a portion of a reduced-pressure, wound-closure system;
• FIGS. 3B and 3C are schematic, plan views of the illustrative embodiment ofFIG. 3A shown in a non-contracted position (FIG. 3B) and a contracted position (FIG. 3C);
• FIG. 4A is a schematic, perspective view of a reduced-pressure connector;
• FIG. 4B is an elevational view of the reduced-pressure connector ofFIG. 4A;
• FIG. 5A is a schematic, cross-sectional view of a portion of another illustrative embodiment of a reduced-pressure, wound-closure and treatment system; and
• FIG. 5B is a schematic, cross-sectional view of a portion of another illustrative embodiment of a reduced-pressure, wound-closure and treatment system.
DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS
• In the following detailed description of the illustrative embodiments, reference is made to the accompanying drawings that form a part hereof. These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is understood that other embodiments may be utilized and that logical structural, mechanical, electrical, and chemical changes may be made without departing from the spirit or scope of the invention. To avoid detail not necessary to enable those skilled in the art to practice the embodiments described herein, the description may omit certain information known to those skilled in the art. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the illustrative embodiments are defined only by the appended claims.
• Referring toFIGS. 1-2, and initially toFIG. 1, an illustrative embodiment of a reduced-pressure, wound-closure andtreatment system100 is presented. The reduced-pressure, wound-closure andtreatment system100 may include a reduced-pressure treatment subsystem102 and a wound-closure subsystem104. The reduced-pressure treatment subsystem102 may be used for treating atissue site106 with reduced pressure. Thetissue site106 may be the bodily tissue of any human, animal, or other organism, including bone tissue, adipose tissue, muscle tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendons, ligaments, or any other tissue. Thetissue site106 may be within a body cavity, such as anabdominal cavity110, and may include various tissue layers including a wound inepidermis108. Treatment with the reduced-pressure treatment subsystem102 may include removing fluids, such as ascites or exudates, delivering reduced pressure, or providing a protective barrier.
• In the illustrative embodiment, the reduced-pressure, wound-closure andtreatment system100 is presented in the context of theabdominal cavity110 and asurface wound111, which has wound edges112. Othersubdermal tissue114 may also have been opened, such as fat tissue, muscles, fascia, etc. Theabdominal cavity110 is shown withabdominal contents116, which form a surface or support.
• The reduced-pressure treatment subsystem102 of the reduced-pressure, wound-closure andtreatment system100 helps to deliver reduced pressure to thetissue site106 and theabdominal cavity110. The reduced-pressure treatment subsystem102 includes a manifold118 disposed within theabdominal cavity110 to distribute reduced pressure within theabdominal cavity110 and to receive fluids. The manifold118 may include or be associated with amanifold member120, or second manifold, in anon-adherent envelope122. Thenon-adherent envelope122 hasapertures124 on a first side andapertures126 on a second, inward-facing (or tissue-facing) side. Theapertures124 and126 facilitate flow of fluids as suggested byarrows128. Theapertures124 and126 may take any shape, such as rectangular openings, circular openings, polygons, slits (elongated slots), etc. Thenon-adherent envelope122 may be formed from a flexible film, such as a polyurethane film, a drape material, or any non-adherent material.
• Reduced pressure may be applied by the reduced-pressure treatment subsystem102 to theabdominal cavity110 and thetissue site106 to help promote removal of exudates, ascites, or other liquids, bacteria, fibrin, dead tissue, toxins, residual blood, etc. Reduced pressure may also be used in certain situations to stimulate growth of additional tissue. In the case of a wound at thetissue site106, the growth of granulation tissue and removal of exudates and bacteria may help to promote healing of the wound. In the situation of a non-wounded or non-defective tissue, reduced pressure may be used to promote the growth of tissue that may be harvested and transplanted to another tissue site. In other situations, fluid removal may be the main reason for applying reduced pressure.
• As used herein, “reduced pressure” generally refers to a pressure less than the ambient pressure at thetissue site106. In most cases, the reduced pressure will be less than atmospheric pressure at which the patient is located. Alternatively, the reduced pressure may be less than the hydrostatic pressure of thetissue site106. Unless otherwise indicated, values of pressure stated herein are gauge pressures.
• The manifold118 and themanifold member120 are disposed in theabdominal cavity110 and may be disposed at or near thetissue site106. Typically, thenon-adherent envelope122, which contains themanifold member120, is disposed against thetissue site106 and, in particular, proximate theabdominal contents116. The manifold118 is disposed adjacent thenon-adherent envelope122. The manifold118 and themanifold member120 may take many forms. The term “manifold” as used herein generally refers to a substance or structure that is provided to assist in applying reduced pressure to, delivering fluids to, or removing fluids from a tissue site, such as thetissue site106. The manifold118 and themanifold member120 typically include a plurality of flow channels or pathways that are interconnected to improve distribution of fluids provided to and removed from the area proximate the manifold118 and themanifold member120. The manifold118 and themanifold member120 may be formed from a biocompatible material that is capable of being placed in contact with tissue and that distributes reduced pressure. Examples of manifolds may include, without limitation, devices that have structural elements arranged to form flow channels, cellular foam, such as open-cell foam, porous tissue collections, and liquids, gels and foams that include or cure to include flow channels.
• The manifold118 and themanifold member120 may be porous and may be made from foam, gauze, felted mat, or any other material suited to a particular biological application. In one embodiment, the manifold118 and themanifold member120 are made from a porous foam that includes a plurality of interconnected cells or pores that act as flow channels. The porous foam may be a polyurethane, open-cell, reticulated foam, such as a GranuFoam® material manufactured by Kinetic Concepts, Incorporated of San Antonio, Tex. Other embodiments may include “closed cells” at certain locations to help direct flow. In some situations, the manifold118, themanifold member120, and thenon-adherent envelope122 may be used to distribute fluids, such as medications, antibacterials, growth factors, and other solutions to thetissue site106. Other layers may be included as part of the manifold118 or themanifold member120, such as absorptive material, wicking material, hydrophobic material, and hydrophilic material.
• A sealingmember132 may be placed over the surface wound111 in theepidermis108 and, in particular, made to overlap the wound edges112 to provide a pneumatic seal. Thus, the sealingmember132 provides a seal over the manifold118 and thenon-adherent envelope122. The sealingmember132 may be a cover that is used to secure the manifold118 andnon-adherent envelope122 at thetissue site106. While the sealingmember132 may be impermeable or semi-permeable, the sealingmember132 is capable of maintaining a reduced pressure at thetissue site106 after installation of the sealingmember132 over themanifold118. The sealingmember132 may be a flexible over-drape or film formed from a silicone based compound, acrylic, hydrogel or hydrogel-forming material, or any other biocompatible material that includes the impermeability or permeability characteristics desired for the intended tissue site.
• The sealingmember132 may further include anattachment device136 to secure the sealingmember132 to the patient'sepidermis108. Theattachment device136 may take many forms; for example, a sealing tape might be used or an adhesive134 may be positioned along a perimeter of the sealingmember132 or any portion of the sealingmember132 to provide a pneumatic seal. The adhesive134 might also be pre-applied and covered with a releasable member (not shown) that is removed at the time of application.
• A first reduced-pressure interface138, such as aport140, or connector, may be used to deliver reduced pressure from a first reduced-pressure delivery conduit142 to the manifold118 to the reduced-pressure delivery conduit142. The first reduced-pressure interface138 may also deliver any exudate, ascites, or other fluids from the manifold118 to the reduced-pressure delivery conduit142. The reduced pressure in the manifold118 pulls the fluid in the direction shown byarrows144 and to the first reduced-pressure delivery conduit142. The first reduced-pressure interface138 permits the passage of fluid from the manifold118 to the first reduced-pressure delivery conduit142. For example, fluids collected from thetissue site106 using themanifold member120 may enter the first reduced-pressure delivery conduit142 via the first reduced-pressure interface138. In another embodiment, the reduced-pressure treatment subsystem102 may exclude the first reduced-pressure interface138, and the first reduced-pressure delivery conduit142 may be inserted directly into the sealingmember132 and themanifold118. The first reduced-pressure delivery conduit142 may be a medical conduit, multi-lumen member, tubing, or any other means for delivering a reduced pressure.
• A reduced-pressure subsystem148 may be used to supply the reduced pressure that is delivered to the first reduced-pressure delivery conduit142. The reduced-pressure subsystem148 may include a first reduced-pressure unit, or source,150 that delivers reduced pressure to asupply conduit152, which delivers the reduced pressure to a three-way valve154. One portion of the reduced pressure may leave the three-way valve154 through a second reduced-pressure delivery conduit156. Another portion of the reduced pressure may leave the three-way valve154 through a reduced-pressure conduit158. Located on the reduced-pressure conduit158 may be any number of devices, such as a reduced-pressure feedback unit160, which may, for example, give feedback to the three-way valve154 concerning the regulation of the reduced pressure within the reduced-pressure conduit158. The reduced-pressure conduit158 delivers the reduced pressure to acanister162, which is operable to hold any fluids delivered to thecanister162 from thetissue site106. Reduced pressure leaving thecanister162 is delivered to the first reduced-pressure delivery conduit142. The first reduced-pressure delivery conduit142 may be referred to as delivering a second reduced pressure, or treatment reduced pressure. The second reduced pressure, or treatment reduced pressure, has been placed, by the reduced-pressure subsystem148, at the desired pressure and conditions for use in reduced-pressure treatment at thetissue site106.
• A number of different devices, e.g.,representative device166, may be added to amedial portion164 of the first reduced-pressure delivery conduit142. The reduced pressure delivered to the first reduced-pressure delivery conduit142 is typically selected to be in the range of −50 mm Hg to −500 mm Hg and more typically in the range −100 mm Hg to −300 mm Hg. Thedevice166 might be a pressure feedback device, a volume detection system, a blood detection system, an infection detection system, a flow monitoring system, a temperature monitoring system, etc. Some of these devices may be formed integrally with other parts; for example, thecanister162 may include one or more filters, e.g., a hydrophobic filter that prevents liquid from exiting.
• There are many ways of developing the reduced pressure to be used with the reduced-pressure, wound-closure andtreatment system100. In the illustrative embodiment shown, the first reduced-pressure unit150 is used for both applications, i.e., for wound closing and for reduced-pressure treatment. In an alternative embodiment, it may be desirable to use the first reduced-pressure unit150 as the source for the second reduced-pressure delivery conduit156 and have a second reduced-pressure unit151 (shown in broken lines) to deliver reduced pressure to the reduced-pressure conduit158.
• As an aspect of the reduced-pressure, wound-closure andtreatment system100, it is also desirable to help provide a closing force to the surface wound111 and, in particular, to apply a closing force between the wound edges112. As shown inFIGS. 1 and 2, the wound-closure subsystem104 may be used for this purpose. The wound-closure subsystem104 develops a closing force represented byarrows170. The closing force is communicated to the patient'sepidermis108 and urges the wound edges112 towards each other. The wound-closure subsystem104 may be a stand alone system for closing any surface wound or used as part of a larger system, e.g., the reduced-pressure, wound-closure andtreatment system100.
• The wound-closure subsystem104 may include a plurality of attachment members, e.g., afirst attachment member172 and asecond attachments member184, that are spaced around and proximate the wound edges112 of the surface wound111. Thefirst attachment member172 has afirst base member174 and afirst wall member176. Thefirst base member174 has afirst side178 and a second, inward-facing (patient-facing)side180. Thefirst base member174 andfirst wall member176 may be made from numerous materials, but a material is preferred that provides some flexibility; for example, thefirst attachment member172 may be formed with thefirst base member174 and thefirst wall member176 made from polypropylene, or a rigid silicone, etc. Afirst adhesive182 or other attachment device may be applied to the second, inward-facing (patient-facing)side180 offirst base member174 to allow thefirst base member174 to be releasably attached directly to a portion of the patient'sepidermis108 or indirectly if a polyurethane film or other sealingmember132 is placed on theepidermis108 first. In addition to the adhesive182, cement, staples, or sutures, or other invasive or non-invasive approaches might be used to attach thefirst base member174 to intact epidermis tissue. Thefirst attachment member172 may be applied directly on top of theepidermis108 or on top of the sealingmember132 so that whatever forces are applied on thefirst attachment member172 are transmitted directly, or indirectly, to theepidermis108. References to applying theattachment member172 to theepidermis108 should be deemed to include application on top of the sealingmember132.
• Almost directly across the surface wound111, e.g., epidermis wound, from thefirst attachment member172 is thesecond attachment member184. Thesecond attachment member184 is analogous to thefirst attachment member172. While the wound-closure subsystem104 only shows twoattachment members172,184, other attachment members may be dispersed around the surface wound111 in a spaced fashion. The twoattachment members172,184 in conjunction with a sealedcontracting member188 allow the closing force, which is represented byarrows170, to be developed, but additional attachment members allow forces to be developed radially across different shapes of the surface wound111.
• One or more of the attachment members, e.g.,attachment member172, has a reduced-pressure interface for receiving reduced pressure from the second reduced-pressure delivery conduit156. For example, as shown clearly inFIG. 2, thefirst attachment member172 may include a second reduced-pressure interface183. The reduced pressure delivered through the second reduced-pressure interface183 is used to develop the closing force.
• The wound-closure subsystem104 includes the sealedcontracting member188 to develop the closing force. The sealedcontracting member188 may be formed from a contracting manifold material, or member, which may be the same type of material as themanifold118. Alternatively, it may be desirable to use a contracting manifold material that has fewer apertures or holes than the material used for the manifold118 or a pneumatic device. In addition, it may be desirable to have a material that will contract less in the vertical (for the orientation shown inFIG. 1) and more in the horizontal, or lateral, plane (for the orientation shown inFIG. 1). The sealedcontracting member188 has afirst side190 and a second, inward-facing (patient-facing)side192. The sealedcontracting member188 also has aperipheral edge194. The sealedcontracting member188 may be sealed by having a first sealing member196 (FIG. 2) applied to thefirst side190 and asecond sealing member198 applied to the second, inward-facingside192 of the sealedcontracting member188 and sealing the peripheral edges194.
• Theperipheral edge194 of the sealedcontracting member188 may be sealed by a peripheral sealingmember200. Alternatively or in addition, thefirst wall member176 may also be used as the peripheral sealing member to seal theperipheral edge194 or another piece of sealed material may be used. Similarly, the second, inward-facingside192 may be sealed by placement against the sealingmember132 or the patient'sepidermis108. The sealedcontracting member188 may also be sealed by being coated with a gas-impervious material. The sealedcontracting member188 may be sealed with the first andsecond sealing members196,198, which may be formed from a polyurethane film or silicone. The first andsecond sealing members196,198 may be ultrasonically welded, or RF welded, or otherwise coupled at their ends to cover theperipheral edge194. When reduced pressure is supplied to the sealedcontracting member188, the sealedcontracting member188 contracts to develop a closing force, which is represented byarrows170.
• The sealedcontracting member188 may be formed with anopening201 on a portion of the sealedcontracting member188 for receiving anextension portion202 of the first reduced-pressure interface138. Theextension portion202 may extend through the sealedcontracting member188 and into themanifold118. In an alternative embodiment, the second reduced-pressure interface183 and the second reduced-pressure delivery conduit156 may be omitted and a portion of the first reduced-pressure interface138 fluidly coupled to the sealedcontracting member188. Thus, in this alternative embodiment, a single reduced-pressure source and conduit may be used for both providing a closing force and for the reduced-pressure treatment. The same is true of the illustrative embodiments ofFIGS. 5A and 5B.
• In operation, the reduced-pressure wound-closure andtreatment system100 may be used in a body cavity, e.g., theabdominal cavity110, by first applying a manifold material on theabdominal contents116. For example, themanifold member120 with thenon-adherent envelope122 may be placed on theabdominal contents116 and the manifold118 disposed proximate thenon-adherent envelope122. The wound edges112 of the surface wound111 may be brought together to the extent possible, and then the sealingmember132 placed onto theepidermis108 to provide a pneumatic seal over the surface wound111. Thefirst attachment member172 may be applied using thefirst adhesive182 to the patient's epidermis108 (or on sealingmember132 as shown) proximate thewound edge112. Similarly, thesecond attachment member184 may be applied proximate thewound edge112 on the opposite side. Either before the first andsecond attachment members172 and184 are applied to theepidermis108, or afterwards, the sealedcontracting member188 is coupled to the first andsecond attachment members172 and184. This coupling may be accomplished in a number of different ways, such as by usingadhesives189 and191, cements, bonding, etc. The first reduced-pressure interface138, which may be the reduced-pressure port140, may be applied such that anextension portion202 reaches into themanifold118. The first reduced-pressure delivery conduit142 may be fluidly coupled to the first reduced-pressure interface138 and fluidly coupled to the first reduced-pressure unit150 (or an optional second reduced-pressure unit151). The second reduced-pressure delivery conduit156 may be fluidly coupled to the second reduced-pressure interface183.
• The reduced-pressure, wound-closure andtreatment system100 is activated such that the first reduced-pressure unit150 delivers reduced pressure through the three-way valve154, which prepares the second reduced pressure, or treatment reduced pressure, that is delivered to the first reduced-pressure delivery conduit142 via the reduced-pressure conduit158 and a first reduced pressure, or closing reduced pressure, that is delivered to the second reduced-pressure delivery conduit156. The treatment reduced pressure delivered through the first reduced-pressure delivery conduit142 is realized at the manifold118, which pulls fluids as suggested byarrows144 and128 and distributes reduced pressure within theabdominal cavity110. At the same time, the closing reduced pressure is delivered through the second reduced-pressure delivery conduit156 to the sealedcontracting member188, which causes the sealedcontracting member188 to contract developing a closing force, represented byarrows170, which pulls the first andsecond attachment members172 and184 towards each other and thereby the wound edges112.
• Referring now toFIGS. 3A-3C, a reduced-pressure closure device300 for providing a closing force on a surface wound is presented. The reduced-pressure closure device300 may be used as part of a reduced-pressure, wound-closure and treatment system, like the reduced-pressure, wound-closure andtreatment system100 ofFIG. 1 or as a stand alone device. The reduced-pressure closure device300 has a plurality of attachment members: afirst attachment member302, asecond attachment member304, athird attachment member306, and afourth attachment member308. Eachattachment member302,304,306,308 has an attachment device for releasably attaching the attachment member to the patient's epidermis (or to a sealing member). For example, thefirst attachment member302 includes an adhesive310 for attaching thefirst attachment member302 to the patient's epidermis and similarly, thethird attachment member306 has an adhesive312. While not shown, the second and fourth attachment members also have a device, such as an adhesive, for securing the attachment members to a patient's epidermis. While non-invasive means are generally considered preferable, it may also be that theattachment members302,304,306, and308 may be secured using sutures, staples, or other invasive mechanical means. In addition, other non-invasive attachment devices may be used, such as cements, bonds, etc.
• Awall314, which is coupled to the plurality of attachment members, forms a circumferential wall having an interior space into which acontracting member316, or contracting material, is placed. The sealedcontracting member316 is attached to thewall314 at least at points proximate to eachattachment member302,304,306,308. Thewall314 may be made of polypropylene, rigid silicone, or other semi-rigid material that allows thewall314 to flex when the sealedcontracting member316 is contracted. Thewall314 may be molded, cast, or formed using other techniques. The sealedcontracting member316 may be made of the same kind of material as the sealedcontracting member188 inFIG. 1. The sealedcontracting member316 needs to be sealed and may be sealed by films, layers, or drapes. The film or other material on the sealedcontracting member316 may be applied to the first side, or a top side318 (for the orientation shown). The sealedcontracting member316 may also be sealed, at least in part, with thewall314 covering the peripheral edge, a sealing member (e.g., sealingmember132 inFIG. 1) providing a seal on the bottom, and a film or drape placed over thetop side318. A sealant may also be sprayed on to thetop side318 to form a seal. The sealedcontracting member316 may simply be enveloped in a polyurethane film that has been welded to form an envelope around thecontracting member316. Anopening320 may be formed through the sealedcontracting member316. Theopening320 allows for placement of part of a reduced-pressure interface that extends to a manifold, e.g., the manifold118 inFIG. 1, below the reduced-pressure closure device300. Theopening320 is analogous to opening201 inFIG. 1 and is optional depending on desired use. A reduced-pressure conduit322 delivers reduced pressure into the sealedcontracting member316. This may be accomplished by directly applying the reduced-pressure conduit322 into any portion of the sealedcontracting member316, but may also be accomplished using a reduced-pressure interface324, e.g., a port, formed on a portion of thewall314.
• In operation, theattachment members302,304,306, and308 are placed around the surface wound and releasably attached to the epidermis (or sealing member). Opposed attachment members, e.g.,attachment members302 and304, are on opposite sides of the surface wound. Thus, for example, thefirst attachment member302 and thefourth attachment member308 may each be releasably secured to one side of a wound at different spaced portions andattachment members304 and306 may each be placed on opposite sides of the wound. As the reduced-pressure closure device300 is installed, the reduced-pressure closure device300 is initially in a non-contracted position. Once installed, reduced pressure is supplied to the reduced-pressure conduit322 and the sealedcontracting member316 contracts causing at least portions of theouter wall314 to be pulled towards one another and in turn to develop closing forces that are transmitted between attachment members, e.g.,302 and304. Thus, the closing force is developed and transmitted to the epidermis through theattachment members302,304,306, and308.FIG. 3B shows the reduced-pressure closure device300 in a non-contracted position, andFIG. 3C shows the reduced-pressure closure device300 in the contracted position.
• Referring now toFIGS. 4A and 4B, one illustrative embodiment of a reduced-pressure connector400 is presented. The reduced-pressure connector400 is operable to fluidly connect two different compartments or areas. In the illustrative embodiment ofFIGS. 4A and 4B, the reduced-pressure connector400 has afirst end402 and asecond end404. Anentry portion406 is formed on thesecond end404. Theentry portion406 may be shaped as an inverted conical section to facilitate insertion through various materials, such as sealing members and manifolds. On thefirst end402, a plurality offlutes408 may be located to facilitate fluid flow. Aflange portion410 may be formed between thefirst end402 and thesecond end404. Theflange portion410 has afirst surface412 and asecond surface414. In an alternative embodiment, thefirst end402 may also be shaped and configured for easy entry through a sealing member or other material. Two different, illustrative applications of the reduced-pressure connector400 are shown inFIGS. 5A and 5B.
• Referring toFIG. 5A, a portion of a reduced-pressure, wound-closure andtreatment system500 is presented. The reduced-pressure, wound-closure andtreatment system500 is analogous in most respects to the reduced-pressure, wound-closure andtreatment system100 ofFIG. 1, and to indicate generally analogous parts, the reference numerals have been indexed by400. A manifold518 is placed within a body cavity, e.g., anabdominal cavity510, to help provide reduced-pressure treatment therein. The manifold518 is shown proximate tosubdermal tissue514 and asurface wound511.
• A sealingmember532 is placed on a patient'sepidermis508 over theabdominal cavity510 and the surface wound511. The surface wound511 has wound edges512. The sealingmember532 has an adhesive534 helping to form a pneumatic seal with the patient'sepidermis508. The sealingmember532 as applied forms a pneumatic seal over theabdominal cavity510.
• Aportion571 of a wound closure device or subsystem is also presented. Theportion571 includes a portion of a sealedcontracting member588. The sealedcontracting member588 is sealed, at least in part, by afirst sealing member596 and asecond sealing member598. The sealedcontracting member588 is attached, at least at certain portions, to the patient'sepidermis508. When reduced pressure is supplied to an interior of the sealedcontracting member588, the sealedcontracting member588 contracts and thereby pulls inward and develops a closing force that is transmitted to the surface wound511.
• In the illustrative embodiments ofFIGS. 5A and 5B, reduced pressure is supplied by a reduced-pressure source to a reduced-pressure conduit542. The reduced-pressure conduit542 is fluidly coupled to a reduced-pressure interface538, which has anextension portion602. In the embodiment ofFIG. 5A, theextension portion602 extends through the sealingmember532 and into themanifold518. Thus, reduced pressure is delivered to the manifold518 and pulls fluids towards theextension portion602 as suggested byarrows544. In this embodiment, the reduced-pressure connector400 has been added. The reduced-pressure connector400 is deployed with thefirst end402 within the interior of the sealedcontracting member588 and thesecond end404 within themanifold518. The reduced-pressure connector400 thereby fluidly couples the interior of the sealedcontracting member588 with themanifold518. Reduced pressure is thereby delivered from the reduced-pressure interface538, to the manifold518, and to the interior of the sealedcontracting member588. The reduced pressure delivered through the reduced-pressure connector400 pulls fluids within the sealedcontracting member588 as suggested byarrows545.
• Thefirst surface412 of the reduced-pressure connector400 abuts the sealingmember532 and thesecond surface414 abuts themanifold518. The reduced-pressure connector400 may be deployed in numerous ways. For example, with reference toFIGS. 3A and 5A, the reduced-pressure connector400 can be placed over a cell, e.g.,cell325, of the sealedcontracting member316, and pushed through the sealing member thereon. Theentry portion406 is shaped to facilitate such an entry. The sealing member thereon should self-seal after insertion, but an additional portion of sealing material could also be added over the insertion point. During insertion, the reduced-pressure connector400 is pushed into the sealedcontracting member316 until thesecond surface414 abuts the second (bottom for orientation shown) sealingmember598 and theentry portion406 extends out of the sealedcontracting member316. Referring to now primarilyFIG. 5A, theentry portion406 can then be inserted through the sealingmember532 and into themanifold518. As noted earlier, numerous approaches may be taken for deploying the reduced-pressure connector400 and the reduced-pressure connector400 may take many different configurations, but the deployed reduced-pressure connector400 functionally provides a fluid coupling of the sealedcontracting member588 and themanifold518.
• Referring now toFIG. 5B, another alternative is shown. In the embodiment ofFIG. 5B, theextension portion602 of the reduced-pressure interface538 terminates within the sealedcontracting member588 and delivers reduced pressure within the sealedcontracting member588. The reduced-pressure connector400 is deployed in the same manner as previously presented, but now delivers reduced pressure to themanifold518. In other words, fluids are drawn through the manifold518 through the reducedpressure connector400 through an interior of the sealedcontracting member588 to theextension portion602 of the reduced-pressure interface538 and then through the reduced-pressure conduit542.
• Although the present invention and its advantages have been disclosed in the context of certain illustrative, non-limiting embodiments, it should be understood that various changes, substitutions, permutations, and alterations can be made without departing from the scope of the invention as defined by the appended claims.

Claims (27)

1. A reduced-pressure, wound-closure system for providing a closing force to a surface wound on a patient, the reduced-pressure, wound-closure system comprising:

a first attachment member for releasably attaching to a first portion of the patient's epidermis proximate an edge of the surface wound;

a second attachment member for releasably attaching to a second portion of the patient's epidermis proximate the edge of the surface wound, wherein the first attachment member is spaced from the second attachment member;

a sealed contracting member coupled to the first attachment member and the second attachment member and operable to contract under reduced pressure; and

wherein a closing force is developed between the first attachment member and the second attachment member when reduced pressure is supplied to the sealed contracting member.

2. The reduced-pressure, wound-closure system ofclaim 1 further comprising a reduced-pressure interface coupled to the second attachment member.

3. The reduced-pressure, wound-closure system ofclaim 1 wherein

the first attachment member comprises a first base member and a first adhesive; and

the second attachment member comprises a second base member and a second adhesive.

4. The reduced-pressure, wound-closure system ofclaim 3 further comprising a wall member coupled to a first base member and a reduced-pressure interface coupled to the wall member.

5. The reduced-pressure, wound-closure system ofclaim 1 wherein the sealed contracting member comprises:

a contracting manifold material having a first side and a second, patient-facing side, and a peripheral edge;

a first sealing member disposed proximate the first side of the contracting manifold material;

a second sealing member disposed proximate the second, patient-facing side of the contracting manifold material;

a peripheral sealing member disposed against the peripheral edge of the contracting manifold material; and

wherein the first sealing member, second sealing member, and peripheral sealing member are operable to pneumatically seal the contracting manifold material.

6. The reduced-pressure, wound-closure system ofclaim 5 wherein the peripheral sealing member comprises a third sealing layer.

7. The reduced-pressure, wound-closure system ofclaim 5 wherein the peripheral sealing member comprises a wall.

8. The reduced-pressure, wound-closure system ofclaim 1 wherein the first attachment member comprises:

a first base member having a first side and a second, inward-facing side;

a first wall coupled to the first base member; and

a first adhesive coupled to the second, inward-facing side of the first base member.

9. A reduced-pressure, wound-closure system for providing a closing force to a surface wound on a patient, the reduced-pressure, wound-closure system comprising:

a plurality of attachment members for releasably attaching to the patient's epidermis proximate an edge of the surface wound;

a circumferential wall coupled to the plurality of attachment members, the circumferential wall for disposing proximate the surface wound;

a sealed contracting member coupled to at least a portion of the circumferential wall and operable to contract under reduced pressure;

a reduced-pressure source fluidly coupled to the sealed contracting member and operable to deliver a reduced pressure to the sealed contracting member; and

wherein a closing force is developed when the reduced pressure is supplied by the reduced-pressure source to the sealed contracting member.

10. The reduced-pressure, wound-closure system ofclaim 9 wherein the circumferential wall comprises polypropylene.

11. The reduced-pressure, wound-closure system ofclaim 9 wherein the circumferential wall comprises rigid silicone.

12. The reduced-pressure, wound-closure system ofclaim 9 wherein each attachment member of the plurality of attachment members comprises a first base member and a first adhesive.

13. The reduced-pressure, wound-closure system ofclaim 9 wherein the sealed contracting member comprises:

a contracting manifold material having a first side and a second, inward-facing side, and a peripheral edge;

a first sealing member disposed proximate the first side of the contracting manifold material;

a second sealing member disposed proximate the second, inward-facing side of the contracting manifold material;

a peripheral sealing member disposed proximate the peripheral edge of the contracting manifold material; and

wherein the first sealing member, second sealing member, and peripheral sealing member are operable to pneumatically seal the contracting manifold material.

14. The reduced-pressure, wound-closure system ofclaim 13 wherein the peripheral sealing member comprises a third sealing member.

15. The reduced-pressure, wound-closure system ofclaim 13 wherein the peripheral sealing member comprises a wall.

16. The reduced-pressure, wound-closure system ofclaim 13 wherein each of the plurality of attachment member comprises:

a first base member having a first side and a second, inward-facing side;

a first wall coupled to the first base member; and

a first adhesive coupled to the second, inward-facing side of the first base member.

17. A reduced-pressure, wound-closure and treatment system for providing a closing force to a surface wound on a patient and for delivering reduced pressure to a tissue site, the reduced-pressure, wound-closure and treatment system comprising:

a wound-closing subsystem comprising:

a first attachment member for releasably attaching to a first portion of the patient's epidermis proximate an edge of the surface wound,

a second attachment member for releasably attaching to a second portion of the patient's epidermis proximate the edge of the surface wound, wherein the first attachment member is spaced from the second attachment member,

a sealed contracting member coupled to the first attachment member and the second attachment member and operable to contract under to reduced pressure,

a closing, reduced-pressure source operable to deliver a first reduced pressure to the sealed contracting member,

wherein a closing force is developed between the first attachment member and the second attachment member when the first reduced pressure is supplied to the sealed contracting member, and

a reduced-pressure treatment subsystem comprising:

a manifold for disposing proximate the tissue site, the manifold operable to distribute reduced pressure and to receive fluids,

a sealing member for placement on the patient's epidermis and operable to form a pneumatic seal over the manifold, and

a treatment, reduced-pressure source operable to deliver a second reduced pressure to the manifold.

18. The reduced-pressure, wound-closure and treatment system ofclaim 17 wherein the closing, reduced-pressure source comprises the treatment, reduced-pressure source.

19. The reduced-pressure, wound-closure and treatment system ofclaim 17 wherein the closing, reduced-pressure source and the treatment, reduced-pressure source comprises:

a reduced-pressure unit;

a reduced-pressure interface;

a reduced-pressure delivery conduit operable to fluidly couple the reduced-pressure unit and the reduced-pressure interface;

wherein the reduced-pressure interface is operable to fluidly couple to the manifold; and

a reduced-pressure connector operable to fluidly couple the sealed contracting member and the manifold.

20. The reduced-pressure, wound-closure and treatment system ofclaim 17 wherein the closing, reduced-pressure source and the treatment, reduced-pressure source comprises:

a reduced-pressure unit;

a reduced-pressure interface;

a reduced-pressure delivery conduit operable to fluidly couple the reduced-pressure unit and the reduced-pressure interface;

wherein the reduced-pressure interface is operable to fluidly couple to the sealed contracting member; and

a reduced-pressure connector operable to fluidly couple the sealed contracting member and the manifold.

21. The reduced-pressure, wound-closure and treatment system ofclaim 17 wherein the second reduced pressure is between −100 mm Hg and −350 mm Hg.

22. A method of manufacturing a reduced-pressure, wound-closure system for providing a closing force to a surface wound on a patient, the method comprising the steps of:

forming a first attachment member for releasably attaching to a first portion of the patient's epidermis proximate an edge of the surface wound;

forming a second attachment member for releasably attaching to a second portion of the patient's epidermis proximate the edge of the surface wound; and

forming a sealed contracting member operable to contract under reduced pressure;

forming a reduced-pressure interface.

23. The method of manufacturing ofclaim 22 further comprising coupling the sealed contracting member to the first attachment member and the second attachment member.

24. The method of manufacturing ofclaim 22 further comprising the step of fluidly coupling the reduced-pressure interface to the sealed contracting member.

25. The method of manufacturing ofclaim 22 further comprising forming a circumferential wall and coupling the circumferential wall to the first attachment member and the second attachment member.

26. The method of manufacturing ofclaim 22 wherein the step of coupling the sealed contracting member to the first attachment and the second attachment member comprises the step of coupling the sealed contracting member to at least a portion of the circumferential wall.

27. A method for providing a closing force to a surface wound on a patient, the method comprising the steps of:

releasably attaching a first attachment member to a first portion of the patient's epidermis proximate an edge of the surface wound;

releasably attaching a second attachment member to a second portion of the patient's epidermis proximate the edge of the surface wound, wherein the first attachment member is spaced from the second attachment member;

providing a sealed contracting member coupled to the first attachment member and the second attachment member and operable to contract when placed under reduced pressure; and

supplying reduced pressure to the sealed contracting member, whereby a closing force is developed between the first attachment member and the second attachment member.

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